Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
J Orthop Res. 2020 Jul;38(7):1529-1537. doi: 10.1002/jor.24661. Epub 2020 Mar 20.
A preclinical rat knee replacement model was recently developed to explore the biological and mechanobiological changes of trabecular resorption for cement-bone interdigitated regions. The goal here was to evaluate the relevance of this model compared with human knee replacement with regards to functional micromechanics. Eight nonsurvival, cemented knee replacement surgeries were performed, the interdigitated gap morphology was quantified, and interface micromotion between cement and bone was measured for 1 to 5 bodyweight loading. Computational fluid dynamics modeling of unit cell geometries with small gaps between trabeculae and cement was used to estimate fluid flow. Gap width (3.6 μm) was substantially smaller compared with cement-bone gaps reported in human knee replacement (11.8 μm). Micromotion at the cement-bone border was also decreased for the rat knee replacement (0.48 μm), compared with human (1.97 μm), for 1 bodyweight loading. However, the micromotion-to-gap width ratio (0.19 and 0.22 for, rat and human), and estimated fluid shear stress (6.47 and 7.13 Pa, for rat and human) were similar. Replicating the fluid dynamic characteristics of cement-bone interdigitated regions in human knee replacements using preclinical models may be important to recapitulate trabecular resorption mechanisms due to proposed supraphysiologic fluid shear stress. Statement of clinical significance: local cement-bone micromotion due to joint loading may contribute to the process of clinical loosening in total joint replacements. This work shows that while micromotion and gap morphology are diminished for the rat knee model compared to human, the motion-to-gap ratio, and corresponding fluid shear stress are of similar magnitudes.
最近开发了一种临床前大鼠膝关节置换模型,以探索水泥-骨交错区域的小梁吸收的生物学和机械生物变化。目的是评估该模型与人类膝关节置换在功能微力学方面的相关性。进行了 8 例非生存性、水泥固定膝关节置换手术,定量了交错间隙形态,并测量了 1 至 5 体重负荷下的骨水泥界面微运动。使用具有小梁和水泥之间小间隙的单元结构的计算流体动力学建模来估计流体流动。间隙宽度(3.6μm)明显小于人类膝关节置换中报告的水泥-骨间隙(11.8μm)。与人类(1.97μm)相比,大鼠膝关节置换的骨水泥边界处的微动也减小(0.48μm),用于 1 体重负荷。然而,大鼠(0.19 和 0.22)和人类(0.19 和 0.22)的微动-间隙宽度比,以及估计的流体剪切应力(大鼠和人类分别为 6.47 和 7.13Pa)相似。使用临床前模型复制水泥-骨交错区域的流体动力学特征对于重现由于拟议的超生理流体剪切应力引起的小梁吸收机制可能很重要。临床意义的陈述:由于关节负荷导致的局部水泥-骨微动可能会导致全关节置换的临床松动过程。这项工作表明,与人类相比,尽管大鼠膝关节模型的微动和间隙形态减小,但运动-间隙比和相应的流体剪切应力的大小相似。